Cox v. Acme Health Services, Inc.

55 F.3d 1300
CourtCourt of Appeals for the Seventh Circuit
DecidedMay 24, 1995
DocketNo. 94-3218
StatusPublished

This text of 55 F.3d 1300 (Cox v. Acme Health Services, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cox v. Acme Health Services, Inc., 55 F.3d 1300 (7th Cir. 1995).

Opinion

COFFEY, Circuit Judge.

Carol Cox appeals from the entry of summary judgment granted in favor of her former employer, Acme Health Services, Inc. (“Acme”), a home health agency in Indianapolis, Indiana. In March of 1993, Cox, who worked for Acme from August, 1990 through February, 1993 as a home health aide, brought suit against Acme seeking unpaid overtime compensation, liquidated damages, as well as costs and attorneys’ fees, claiming that Acme wrongfully refused to pay her overtime wages for the hours she worked in excess of forty per week in violation of § 7(a)(1) of the Fair Labor Standards Act (“FLSA”), 29 U.S.C. § 207(a)(1). The district court granted Acme’s motion for summary judgment, finding that the services Cox performed were “companionship services” within the meaning of an exemption to the FLSA’s general overtime pay requirements. See id. at § 213(a)(15); 29 C.F.R. § 552.6 (1994). We affirm.

I. BACKGROUND

A. The Statutory and Regulatory Framework

The FLSA requires employers to pay domestic service employees overtime pay at the rate of one and one-half times the regular wage for hours worked in excess of forty in any single work week. 29 U.S.C. § 207(a)(1).1 However, this overtime pay requirement does not apply to an “employee employed in domestic service employment to provide companionship services for individuals who (because of age or infirmity) are unable to care for themselves (as such terms are defined and delimited by the regulations of the Secretary [of Labor]).” Id. at § 213(a)(15). The regulation promulgated pursuant to this section defines the term “companionship services” as:

those services which provide fellowship, care, and protection for a person who, because of advanced age or physical or mental infirmity, cannot care for his or her own needs. Such services may include household work related to the care of the aged or infirm person such as meal preparation, bed making, washing of clothes, and other similar services. They may also include the performance of general household work: Provided, however, That such work is incidental, i.e., does not exceed 20 percent of the total weekly hours worked. The term “companionship services” does not include services relating to the care and protection of the aged or infirm which require and are performed by trained personnel, such as a registered or practical nurse. While such trained personnel do not qualify as companions, this fact does not remove them from the category of covered domestic service employees when employed in or about a private household.

[1306]*130629 C.F.R. § 552.6 (1994) (emphasis in original).

Within this federal statutory and regulatory framework, we must analyze the role of a home health aide working for a home health agency in the State of Indiana. The nature of a home health aide’s training and duties lies at the crux of this dispute. See Alex v. Chicago, 29 F.3d 1235, 1237 (7th Cir.), cert. denied, — U.S. -, 115 S.Ct. 665, 130 L.Ed.2d 599 (1994) (nature of training and duties of paramedics crucial to the determination of exemption from overtime pay requirements for “fire protection activities”). Home health aides provide basic personal health care services to the aged or infirm who can no longer care for themselves, and, under the direction of registered nurses, assist other medical care providers, including therapists, in carrying out various assignments related to patient care:

The home health aide shall be assigned to a particular patient by a registered nurse. Written instructions for patient care shall be prepared by a registered nurse or therapist as appropriate. Duties may include the performance of simple procedures as an extension of therapy services or nursing service, personal care, ambulation and exercise, household services essential to health care at home, assistance with medications that are ordinarily self-administered, reporting changes in the patient’s conditions and needs, and completing appropriate records.

410 Ind.Admin.Code § 17 — 6—l(i).

Although home health aides work under the close supervision of registered nurses, federal and state regulations require home health aides to have successfully completed seventy-five hours of general training,2 including sixteen hours of practical training in the following' areas:

(1) Communication skills.
(2) Observation, reporting, and documentation of patient status and the care or service furnished.
(3) Reading and recording temperature, pulse, and respiration.
(4) Basie infection control procedures.
(5) Basic elements of body functioning and changes in body function that must be reported to an aide’s supervisor.
(6) Maintenance of a clean, safe, and healthy environment.
(7) Recognizing emergencies and knowledge of emergency procedures.
(8) The physical, emotional, and developmental needs of and ways to work with the populations served by the home health agency, including the need for respect for the patient, the patient’s privacy, and the patient’s property.
(9) Appropriate and safe techniques in personal hygiene and grooming that include the following:
(A) Bed bath, sponge, tub, or shower
bath.
(B) Shampoo, sink, tub, or bed.
(C) Nail and skin care.
(D) Oral hygiene.
(E) Toileting and elimination.
(10) Safe transfer techniques and ambulation.
(11) Normal range of motion and positioning.
(12) Adequate nutrition and food intake.
(13) Any other task that the home health agency may choose to have the home health aide perform.

410 Ind.Admin.Code § 17-6-l(e); 42 C.F.R. § 484.36(a) (1994). Home health aides must also receive at least twelve hours of in-service training each year. 410 Ind.Admin.Code § 17 — 6—1(h)(1)(B); 42 C.F.R. § 484.36. Federal and state regulations require a registered nurse to conduct home health aide training and testing to ensure each home health aide’s competency in the specified skill areas at least once a year. 410 Ind.Admin.Code § 17 — 6—1(g); 42 C.F.R. § 484

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55 F.3d 1300, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cox-v-acme-health-services-inc-ca7-1995.